角膜塑形术在青少年近视控制中的作用  

The control effect of orthokeratology on adolescent myopia

作　　者：李秀红[1] 钟梅[1] 朱豫[1] 王卫群[1] 吕勇[1] 

机构地区：[1]郑州大学第一附属医院眼科河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2017年第7期491-495,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨角膜塑形术在青少年近视控制中的作用及配戴舒适度、并发症。方法前瞻性临床研究。对2012年1月至2014年7月验配角膜塑形镜的近视者80例（158只眼）、单光足矫框架镜近视者80例（160只眼）及LASIK矫正近视手术者80例（160只眼），随访2年。记录三组戴镜前及戴镜后近视度（等效球镜度，sE）、眼轴长度（AL）、裸眼视力（UCVA）、配戴舒适度及并发症情况。结果LASIK组术后1d与术后2年的AL相比差异无统计学意义（t=0．631，P=0．741），术后各时间点UCVA相比差异无统计学意义（F=1．461，P=0．102）。配戴后2年框镜组和塑形镜组的sE和AL均有所增加，两组sE、AL的增加量相比差异均有统计学意义（t=29．570，22．220；P=0．000，0．000）。塑形镜组戴镜后1个月UCVA逐渐提高，之后趋于稳定，随访期间无严重并发症发生。结论角膜塑形术在UCVA及AL的稳定性方面，不及LASIK。但与框镜组相比，角膜塑形术对控制青少年近视眼轴增长及近视进展方面效果显著；并有较高的舒适度和安全性。Objective To investigate the control effect, the degree of comfort and the complications of orthokeratology on adolescent myopia. Methods Prospective clinical study. The data of 158 eyes of 80 cases with adolescent myopia wearing oiihokeratology , 160 eyes of 80 eases with adolescent myopia wearing full correction single vision spectacles, and 160 eyes of 80 cases with myopia treated by LASIK were collected from January 2012 to July 2014. The follow-up time was 2 years. The spherical equivalent （SE） of diopter of myopia and axial length（AL） before and after treatment, the uncorrected visual acuity （UCVA）, degree of comfort and complications in the three groups were recorded. Results There was no statistical difference in AL of LASIK group between 1 day and 2 years after surgery （ t = 0. 631, P = 0.741 ）. The difference in UCVA was not statistically significant at each time point after LASIK （F = 1. 461, P =0. 102）. Two years after wearing, the SE and AL of spectacles group and orthokeratology group increased respectively, and the difference between the two groups in increment of both items were statistically significant （ t = 29. 570, 22. 220; P = 0.000, 0. 000）. The UCVA was gradually improved 1 month after orthokeratology, and kept stable later. No obvious discomfort or serious complication occurred during the follow-up period in 3 groups. Conclusion The UCVA and AL of LASIK group is better than orthokeratology group. But the control effect of orthokeratology on adolescent myopia is significant with high suitability and safety of adole scent myopia, and also have a good comfort and security.

关 键 词：角膜塑形术 近视 青少年 LASIK 眼轴长度 并发症 

分 类 号：R779.6[医药卫生—眼科]